Primary ABCD Survey A B C D ACLS

Primary ABCD Survey • 叫 叫 A B C D 持 續 心 肺 復 甦 術 ACLS JOINT COMMITTEE E-LEARNING

Primary ABCD Survey 快看板電擊板檢測心律 VF/Pulseless VT 電擊 持續CPR並進入 再次ABCD評估 ACLS JOINT COMMITTEE E-LEARNING

利用急救五大步驟 心跳停止 1. Primary ABCD Survey 2. Secondary ABCD Survey 心跳停止前後 3. O 2–IV–monitor–fluid 4. Temp–HR–BP–RR 5. Tank–volume–pump–rate ACLS JOINT COMMITTEE 再次ABCD評估 提醒細節，提高 ACLS成功率！ E-LEARNING

再次ABCD評估 Secondary ABCD Survey • A = Airway – 插管，維持呼吸道通暢 • B = Breathing – 確認插管位置，給氧 於CPR時，執 行再次ABCD 評估，增加急 救成功率！ • C = Circulation – IV，Monitor，輸液給藥 • D = Differential Diagnosis (Think!) – 找原因： 6 H 6 T ACLS JOINT COMMITTEE E-LEARNING

D = Differential Diagnosis （1） • 找尋治療可能的可逆性原因(6 Hs) 1. Hypoxia 缺氧 氣管插管併 100%氧氣使用 2. Hypovolemia 低血容積 輸液和/或輸血 3. Hypothermia 低體溫 回溫 4. Hydrogen ion (acidosis) (酸中毒) Na. HCO 3 (1 m. Eq/kg) 5. Hypo-/Hyper-kalemia 低/高血鉀 Ca. Cl 2，Na. HCO 3 (1 m. Eq/kg)，RI+G/W 6. Hypoglycemia 低血糖 G/W ACLS JOINT COMMITTEE E-LEARNING

再次ABCD評估 Secondary ABCD Survey • A = Airway – 插管，維持呼吸道通暢 • B = Breathing – 確認插管位置，給氧 於CPR時，執 行再次ABCD 評估，增加急 救成功率！ • C = Circulation – IV，Monitor，輸液給藥 • D = Differential Diagnosis (Think!) – 找原因： 6 H 6 T ACLS JOINT COMMITTEE E-LEARNING

參考文獻 • • 1. American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. International Consensus on Science. Circulation. 2005; 112: IV-1–IV-211. 2. ILCOR 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2005; 112: III-1–III 125. 3. Zaritsky A, Morley P. The evidence evaluation process for the 2005 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2005; 112: III-128–III-130. 4. Billi JE, Eigel B, Montgomery WH, Nadkarni V, Hazinski MF. Management of conflict of interest issues in the American Heart Association emergency cardiovascular care committee activities 2000 -2005. Circulation. 2005; 112: IV-204–IV-205. ACLS JOINT COMMITTEE E-LEARNING